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51 Cards in this Set

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bring stethoscopes to class next week. The elecricla nodes in the heart. Know A/V nodes and S/A nodes well. what does the size of the heart have to do w/ age?
age has to do w/ size
physical conditioning, bigger it is and then slower it is
a large heart can indicate heart disease. SO heart can be large from exercise AND disease
where does our heart sit? landmarks are: behind angle of louie?
on top of the diaphram,
angle of louie, down a few ribs.
what shape is the heart. a triangle. upside down triangle. it is 2 pumps together. so failure is going to be
right sided failure or left
sided failure so 2 things here
ave. adult has 5 liters per minute pumped.
describe systole and idastole
systole = contraction
diastole = relax or at rest
so in systole it is sending blood. mitrail & tricusp are closing and otherer open
what makes valves open and close?
due to pressure, and blood flows only in one direction.
depolarization must happen in order for heart to
ions moving across cell membrane cause
selective permeability to ions creates an electrical imbalance: what?
action potential
cardiac cell at rest has
internal (-) charge
charge outside cell is
release of single impulse does
begins polarization
cell wall permeability
ions move across membranes and the _______ changes
Na+ fastest
K+ faster
Ca++ slow
what else?
if we get a hi potassium or a low potassium we are worried about
heart function
there is a potential of dyrrhymia
Conduction system:
orderly conduction is important
inherent rhythmic action (rate)
(depends on location of pacemaker)
normally sequential
what is the normal pacemaker?
the S/A node is the normal pacemaker and wants to be 60-100 a minute. as the pacemaked moves down the heart the beat will decrease!
our conduction system is sequential. so normal sequence is:

-SA then -AV
Bundle of HIS
R and L bundles
Purkinje Fibers
this is the normal conduction route or sequence
stroke volume:
amt of blood ejected per beat
how much blood in av. adult?
look it up
when we palpate a pulse, what are we really asessing?
its actually a wave of blood. in the foot you can feel a wave of blood.
control of stoke vol.
contractility: force of contraction
preload: degree of stretch
afterload: ?
systemic resistance
Preload is degree of stretch. what is this?
how much the ventricle can take in, a good thing. its filling, and degree of stretch affects contactbility. the more the heart stretches too much it will act like a stretched out baloon and not work either.
starling heart : the more the heart stretches, the more ...
it gets to something . look it up
what is afterload?
its the systemic resistence
all the pressure out there in the system
the more resistence, the heart has to work harder. what processes would cause this/
anyting that narrows the vessels
what does stonosis mean
narrowing. so a vessel that is stonisis is hard to pump thru. this has to do w/ preload and afterload
Starlings law is
amount of load does somehting, look it up
what is Atrial kick?
(it accounts for 25-30% of CO)
its that help the atrical gives to help to fill the ventricles for really good ventrical output (I think)
what other conditions help Atrial Kick?
I don't know ?????????????????
a pacemaker can help with Atrial Kick.
Now: Heart Rate and factors that influence it:
metabolic activity
amt of o2 avaliable
pH of body fluids
body temp
endocrine: thyroid & adrenals
no answer but more notes
pH=the acid the higher heart rate
endocrine hyperthyroid has higher heart rate. the adrneal will make heart rate go up
EKG or Electrocardiogram
quick, easy, non-evasive
shows electrical activity
shows rate
also detects?
Ischemia (lack of o2)
old and new infactions
Echocardiogram is"
non-evasive ultrasound
size: enlargment
motion: valves, contraction
walls: if thickened
Homosysteine is?
serum test
byproduct of breakdown of AA
normally changed to sulfate: out in urine
casues vessel inflammation
C-Reative Protein
produced by the liver
marker for inflammation
appears/disappears quickly
what else?
linked to acute coronary syndrome
is normally up w/ autiommune disease
part of the lipid profile
form of fat in bloodstream
transported by VLDL (and LDL
can help ID risk of coronary and vascular disease
male 40 - 160 mg/gl
female 35-135 mg/dl
: released when ventricular disatolic pressure rises. elevated in:
ventricular hypertophy
severe HTN, CHF
what the diff b/t hyperplasia and hyerthrophy:?
look it up
Ejection Fraction:

% of end-diastolic vol. ejected/stroke
normally 55% to 75% of end-diastolic vol. is ejected by normal heart
what else?
used to measure cintractility
severe if less than 40% their ejection is really poor
Troponin T:
elevates in 3 to 5 hrs
remains elevated up to 14 days
affected by sleletal muscle
what else?
affected by renal disease
Body mass index:
Weight Status
below 18.5 underweight
-18.5 to 24.9 normal
-25 to 29.0 overweight
-30.0 & above obese
BMI = weight/height in in X 703

EX: 220lbs and is 6'3'' = BMI
of 27.5 and this is overweight
EKG = picyture of heart on a graph, on paper or oscilloscope
standard 12 lead
holter monitor
what is telemetry?
a portable signaling thing to a heart monitor thing
whats a holter monitor?
24 - 48 hours tracks the heart
standard 12 lead EKG
place multiple electrodes on body what will these do?
read electrical activity of heart from different angles
what does the telemetry do?
3 leads are placed on chest
pt can ambulate w/ leads in place
shows electrical activity fron one angle
displayed on O scope
A 12 lead EKG looks at the left ventricle from diff. views.
What can you see w/ a EKG?
past or current ischemic damage
electolyte imbalance
it is all electrical antivity only
does not show actual heart motion
brushing their teeth and get an interference? what is that called?
an artifate
cardiac monitor paper.
marked w/ squares
large squares and small squares
each large square contains 5 small squares
each smal square is = 0.04 sec
what else?
each large sq. is = 0.20 sec
small lines at the top of the paper mark the seconds
Determining heart rate:
1) use this method if the rhythm is regular
count # of large boxes b/t 2 R waves. Divide this # into 300. what next
!2) use this method if th rhythm is irregular.
count # of R waves in 6 seconds and time slsala;fjasf
an EKG tracing is a group of waves that record the elcteical signal
we id the peices w/ letters:
theese correscpond to variouspartos of the heart
all together = a complex or waveform
usually occur in alphi order bUT not always
some may be absent
some may appear more than once in the same oomplex
The P
the ORS
The T
so what?
the P wave = the artrium p wave
the big QRS complex wave = the ventricle wave
the T wave (biiger than p wave) its the resting of the ventricule its repolarizing.